PM&R最新文献

{"title":"Common peroneal neuropathy following significant weight loss induced by tirzepatide therapy.","authors":"Joseph Wentling, Michael Forte, Taylor A Colon, Evan Reuter","doi":"10.1002/pmrj.13409","DOIUrl":"https://doi.org/10.1002/pmrj.13409","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Errors and omissions: Incomplete or incorrect documentation on admission to inpatient rehabilitation.","authors":"John P Rizik, Gregory White, Michal Getz, Adam G Lamm","doi":"10.1002/pmrj.13366","DOIUrl":"https://doi.org/10.1002/pmrj.13366","url":null,"abstract":"<p><strong>Background: </strong>As patients move from acute to postacute care settings, clinicians rely on complete and accurate documentation. Errors or omissions during transitions in care expose patients to physical harm, may result in lower institutional quality metrics, expose institutions to medicolegal risk, and may contribute to provider burnout.</p><p><strong>Objective: </strong>To identify the frequency and types of errors encountered in discharge paperwork from acute care hospitals for patients being admitted to an acute inpatient rehabilitation facility.</p><p><strong>Design: </strong>Cohort study.</p><p><strong>Setting: </strong>Tertiary freestanding acute inpatient rehabilitation facility.</p><p><strong>Patients/participants: </strong>The primary admitting provider in two 1-month study periods 1 year apart was sent an electronic survey for each admission completed to identify the presence of a documentation error. Providers were asked to characterize the type of error including the name(s) of medication(s) involved, if applicable.</p><p><strong>Main outcome measures: </strong>Presence of an error or omission in discharge paperwork, the type of error, and any medication(s) involved in medication errors.</p><p><strong>Results: </strong>Errors in discharge paperwork were noted in 58 (30.4%) unique admissions out of 191 completed surveys in August 2021 and in 42 (23.2%) unique admissions out of 194 completed surveys in August 2022. Medication errors were most commonly encountered (61.0% and 70.5% of all errors, respectively). Less common errors involved code status, weightbearing status, and bracing instructions, among others.</p><p><strong>Conclusions: </strong>High rates of documentation errors predominantly involving medications were noted during both study periods, which expose patients to the risk of physical harm, jeopardize hospital quality metrics, and expose institutions and providers to medicolegal risk. The presence of such errors requires heightened clinician vigilance to identify and remedy, which may lead to higher levels of provider stress and burnout. Collaboration with acute care hospitals is necessary to further reduce documented rates of errors in discharge paperwork in this systems-level challenge.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic development of an implementation strategy to promote high-intensity rehabilitation uptake in skilled nursing facilities.","authors":"Lauren A Hinrichs-Kinney, Emma H Beisheim-Ryan, Katie A Butera, Melissa Braaten, Jodi Summers Holtrop, Jennifer E Stevens-Lapsley","doi":"10.1002/pmrj.13389","DOIUrl":"https://doi.org/10.1002/pmrj.13389","url":null,"abstract":"<p><strong>Background: </strong>Effective implementation of rehabilitation research into clinical practice is imperative to optimize patient outcomes; however, limitations persist. A systematic approach to develop implementation strategies can address known limitations.</p><p><strong>Objective: </strong>To detail the systematic process for developing a strategy to implement high-intensity resistance rehabilitation (HIR) in skilled nursing facilities (SNFs), to be evaluated in future pragmatic trials.</p><p><strong>Design: </strong>Expert-informed, theory-driven development study.</p><p><strong>Setting: </strong>Academic research institute.</p><p><strong>Participants: </strong>An expert panel of clinician-researchers (n = 5) and SNF clinicians (n = 4) with experience implementing HIR collaborated on strategy development.</p><p><strong>Interventions: </strong>Development followed steps of implementation mapping: (1) identifying barriers and facilitators, (2) defining performance objectives, (3) selecting theory and evidence to develop the strategy, (4) producing the implementation strategy, and (5) planning for evaluation. Panel consensus meetings were held throughout the process.</p><p><strong>Main outcome measure(s): </strong>Not applicable.</p><p><strong>Results: </strong>Barriers and facilitators were identified at patient, clinician, and facility levels. Performance objectives included: (1) screening all patients for suitability, (2) dosing rehabilitation interventions at a high intensity for appropriate patients, (3) monitoring and adjusting dosage per patient response, and (4) progressing patients each session. Adult learning theories, social cognitive theory, and a review of the literature on effective implementation strategies guided development of a multicomponent implementation strategy: (1) train and educate clinicians (e.g., online modules); (2) provide interactive assistance (e.g., external implementation facilitator, check-ins); (3) support clinicians (e.g., job aids); and (4) change infrastructure (e.g., equipment provision). An evaluation plan was constructed.</p><p><strong>Conclusion: </strong>This work illustrates a systematic approach, guided by implementation, adult learning, and behavior change principles, for developing an implementation strategy to promote HIR implementation in diverse SNFs. Health care leaders, clinicians, and researchers can replicate this approach to enhance rehabilitation practices, improving patient care and outcomes. Future work will evaluate this strategy for HIR implementation in SNFs.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical medicine and rehabilitation and interdisciplinary spine clinic referrals are associated with increased conversion to spine surgery.","authors":"Karissa Yamaguchi, Stella Biehl, Murad Alostaz, Aiyush Bansal, Allen Benge, Luke Verst, Spencer Raub, Patricia Lipson, Rakesh Kumar, Venu Nemani, Andrew Friedman, Philip K Louie","doi":"10.1002/pmrj.13390","DOIUrl":"https://doi.org/10.1002/pmrj.13390","url":null,"abstract":"<p><strong>Background: </strong>Currently, in the United States, many patients receive immediate referral to a spine surgeon upon concern for any spine pathology, prior to undergoing conservative management. However, research has demonstrated that referrals to spine surgeons for common problems such as low back pain are often not indicated. This situation leads to inefficient care, delayed conservative treatments, and longer wait times for available surgical consultations. Therefore, this highlights an opportunity to improve efficiency in care for patients and clinicians through proper triaging for spine surgery.</p><p><strong>Objective: </strong>To examine whether clinicians from physical medicine and rehabilitation (PM&R) and nonsurgical interdisciplinary spine clinics effectively triaged patients for spine surgeon evaluations.</p><p><strong>Design: </strong>Retrospective study (May 2022-April 2023) of consecutive new patients referred to a spine surgery clinic. Charts were evaluated to determine if surgery was indicated at the initial spine surgeon evaluation. The proportion of patients indicated for surgery was calculated based on the source of referral. An odds ratio (OR) of patients indicated for surgery was calculated to compare different specialty groupings.</p><p><strong>Setting: </strong>All new consecutive patients evaluated between May 2022 and April 2023 on the panels of two fellowship-trained orthopedic spine surgeons at a single outpatient clinic in the Pacific Northwest United States were included. Patients whose symptoms were associated with infections, trauma, and tumors were also excluded as these patients typically have elevated clinical acuity.</p><p><strong>Results: </strong>Of 503 patients, 247 (49.1%) were indicated for and underwent spine surgery within 6 months of initial evaluation. PM&R referrals were more likely to result in surgery compared to primary care physician referrals (OR, 2.88 [95% CI, 1.73-4.79]). Patients referred from interdisciplinary spine clinics were also more likely to undergo surgery compared to those referred by a primary care physician (OR, 2.36 [95% CI, 1.56-3.57]) or generalists (OR, 2.37 [95% CI, 1.58-3.57]).</p><p><strong>Conclusion: </strong>Referrals from PM&R and interdisciplinary spine clinics were significantly associated with increased odds of being indicated for surgery at the time of initial evaluation with a spine surgeon. These findings highlight how interdisciplinary efforts may reduce the nonoperative consultations seen by surgical spine clinicians.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting medical prognosis in patients with glioblastoma during inpatient rehabilitation using bed mobility function.","authors":"Tomasz Gruchala, Christopher W Lewis, Kathryn Abplanalp, Prakash Jayabalan, Theresa L Walunas, Jodi L Johnson, Derek A Wainwright, Rimas V Lukas, Gayle Spill, Ishan Roy","doi":"10.1002/pmrj.13402","DOIUrl":"https://doi.org/10.1002/pmrj.13402","url":null,"abstract":"<p><strong>Background: </strong>Determining appropriate suitability and goals for inpatient rehabilitation of patients with glioblastoma, isocitrate dehydrogenase-wildtype (GBM) requires real-time prognostic information. Functional measures, such as bed mobility, are standardized scores that can be assessed by members of the care team at the bedside and may aid medical prognostication.</p><p><strong>Objective: </strong>To analyze the association between bed mobility function during inpatient rehabilitation and 6-month survival post rehabilitation in people with GBM.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Academic inpatient rehabilitation facility (IRF).</p><p><strong>Patients: </strong>One hundred seventy patients with GBM admitted to an IRF over 4.5 years.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure: </strong>Survival 6 months post rehabilitation, regardless of disease progression or events.</p><p><strong>Results: </strong>Univariate analyses showed admission (odds ratio [OR] = 1.63, 95% confidence interval [CI] 1.23-2.20; p < .001), discharge (OR = 1.72, 95% CI 1.39-2.16; p <. 001) and gain in bed mobility (OR = 1.64, 95%CI 1.26-2.20; p < .001) were associated with survival. In multivariate analyses adjusting for demographic and clinic variables, admission (OR = 1.91, 95% CI 1.39-2.69; p < .001), discharge (OR = 1.72, 1.38-2.19; p < .001), and gain in bed mobility (OR = 1.62, 95% CI 1.20-2.22; p = .002) were each independently associated with survival. Bed mobility was also independently associated with survival compared to other standard functional independence measures collected in IRF at discharge (OR = 1.88, 95% CI 1.14-3.23; p = .017) and for gain (OR = 1.65, 95% CI 1.10-2.53; p = .018). There was a significant difference in survival between patients with admission bed mobility scores of ≤1 or ≥2 (HR = 3.68, p < .001), discharge scores of ≤1 or ≥2 (HR = 5.72, p<. 001), or a gain of ≤0 or ≥1 (HR = 3.13, p < .001).</p><p><strong>Conclusions: </strong>Bed mobility function may serve as a predictor of survival in GBM, suggesting that it could be used during inpatient rehabilitation to help determine functional goals for patients with GBM.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower-extremity asymmetry and patellofemoral pain in young female dancers: A 2-year follow-up.","authors":"Nili Steinberg, Yael Sitton, Michal Shenhar, Itzhak Siev-Ner","doi":"10.1002/pmrj.13393","DOIUrl":"https://doi.org/10.1002/pmrj.13393","url":null,"abstract":"<p><strong>Background: </strong>Patellofemoral pain (PFP) is a prevalent injury in young dancers, with low recovery rates. This study aimed to assess PFP in young female dancers over a 2-year period while examining associations between lower-limb asymmetry and PFP.</p><p><strong>Methods: </strong>Thirty-two female dancers (aged 13.6 ± 2.9 years) were clinically examined for PFP at the baseline, 12 months later (first follow-up), and 24 months later (second follow-up). Dancers were also assessed for anthropometric measurements, joint range of movement (ROM), and muscle strength.</p><p><strong>Results: </strong>PFP was identified in 46.9%, 53.1%, and 46.9% of the dancers at the three time points, respectively. When comparing the baseline to the second follow-up, 21.9% of the dancers had recovered, 21.9% had developed PFP, and 25.0% had remained with PFP. Only 31.3% had remained healthy throughout this period. Examining muscle-strength-asymmetry in the four groups of dancers, significant interactions (time × group) were found for ankle plantar-flexor, knee extensor, hip abductor, and hip extensor muscle strength (p < .001), indicating that dancers in the developed-PFP or remained-PFP groups had greater muscle-strength-asymmetry at baseline than the recovered or healthy groups. Significant differences in the prevalence of asymmetry between the four groups were found for joint ROM (ankle en-pointe, hip abduction, hip external rotation, and hip internal rotation) (p < .05); and significant differences in the prevalence of asymmetry between the three time points were found for joint ROM (ankle en-pointe, ankle dorsiflexion, hip extension, hip abduction, and hip external rotation) (p = .05).</p><p><strong>Discussion: </strong>A high prevalence of dancers had PFP, with a limited prevalence of recovery. Dancers who developed PFP or remained with PFP had greater muscle strength and joint ROM asymmetry than their healthy or recovered counterparts.</p><p><strong>Conclusion: </strong>Screening for and addressing asymmetries in strength measures may modify the risk for PFP in dancers.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise improves stair climbing performance after stroke: A systematic review of randomized trials with meta-analysis.","authors":"Lucas Rodrigues Nascimento, Amanda Marcele de Souza Oliveira, Grazyelle Maria Silva Pereira de Moraes, Augusto Boening, Kênia Kiefer Parreiras de Menezes, Estephane Mendes de Souza, Guilherme Silva Nunes, Stella Maris Michaelsen","doi":"10.1002/pmrj.13373","DOIUrl":"https://doi.org/10.1002/pmrj.13373","url":null,"abstract":"<p><strong>Background: </strong>Exercises have been used to improve outcomes after stroke.</p><p><strong>Objective: </strong>To examine the effects of planned, structured, and repetitive exercises of the paretic lower limb for improving stair climbing performance after stroke.</p><p><strong>Data sources: </strong>MEDLINE, EMBASE, Cochrane Library, Allied and Complementary Medicine Database, and Physiotherapy Evidence Database (PEDro).</p><p><strong>Review methods: </strong>Only randomized clinical trials were included. Participants in the reviewed studies were adults at any time after stroke. The experimental intervention consisted of exercises for the paretic lower limb in comparison with no intervention/placebo. Outcome data related to stair climbing performance were extracted from the eligible trials and combined in meta-analysis. The quality of included trials was assessed by the PEDro scores. The quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system.</p><p><strong>Results: </strong>Nine trials, involving 314 participants, were included. The examined interventions were strength training, task-oriented training, or a combination of strength training with aerobic or task-oriented training. A random-effect meta-analysis provided very low-quality evidence that exercises improved stair climbing performance by standardized mean difference 0.4 (95% confidence interval [CI], 0-0.8). When only trials that reported the time to ascent/descent stairs were pooled, exercise improved stair climbing performance by 3.4 seconds (95% CI, 0.4-6.5). No trials examined the maintenance of benefits beyond the intervention period.</p><p><strong>Conclusion: </strong>This systematic review provided very-low-quality evidence that 6 weeks of planned, structured, and repetitive exercises, performed during 50 minutes, four times per week, improve stair climbing performance of moderately disabled individuals with chronic stroke.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of kilohertz versus low-frequency electrical stimulation of the wrist extensors in patients after stroke: A randomized crossover trial.","authors":"Sarah Tenberg, Jonas Weinig, Daniel Niederer, Lutz Vogt, Markus Leisse, Steffen Müller","doi":"10.1002/pmrj.13368","DOIUrl":"https://doi.org/10.1002/pmrj.13368","url":null,"abstract":"<p><strong>Background: </strong>Electrical stimulation is an effective treatment method for improving motor function after stroke, but the optimal current type for patients with stroke and arm paresis remains unclear.</p><p><strong>Objective: </strong>To compare the effects of kilohertz frequency with low-frequency current on stimulation efficiency, electrically induced force, discomfort, and muscle fatigue in patients with stroke.</p><p><strong>Design: </strong>A randomized crossover study.</p><p><strong>Setting: </strong>Neurological inpatient rehabilitation clinic in Germany.</p><p><strong>Participants: </strong>A total of 23 patients with arm paresis after stroke within the last 6 months were recruited, 21 were enrolled, and 20 completed the study (7 females; mean ± SD: 66 ± 12 years; 176 ± 11 cm; 90 ± 19 kg; 57 ± 34 days since stroke).</p><p><strong>Intervention: </strong>All patients underwent both kilohertz and low-frequency stimulation in a randomized order on 2 days (48-hour washout). Each day included a step protocol with a gradual increase in stimulation intensity, starting at the first measurable force (up to 12 steps, 1 mA increments, 8 seconds stimulation, 60 second rest) and a fatigue protocol (30 repetitions, 8 second stimulation, 3 second rest).</p><p><strong>Main outcome measure: </strong>Primary outcome was stimulation efficiency (electrically induced force/stimulation intensity) [N/mA], measured during each step of the stepwise increase in current intensity protocol.</p><p><strong>Results: </strong>Linear-mixed-effects models showed significantly higher stimulation efficiency for low-frequency stimulation (mean difference 0.14 [95% confidence interval, 0.01-0.27 N/mA], p = .031). However, current type did not significantly affect electrically induced force, level of discomfort, or muscle fatigue (p > .05).</p><p><strong>Conclusion: </strong>The findings suggest that low-frequency stimulation is more efficient than kilohertz-frequency stimulation. However, both current types yield similar effects on force, discomfort, and fatigue, making them both viable options for wrist extensor stimulation in patients after stroke. Considering the variability among individuals, customizing the current type based on electrically induced force and perceived discomfort may enhance therapeutic outcomes. Further research on the long-term treatment effects of both current types is warranted.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided injections for the retrotrochanteric region: A cadaveric investigation.","authors":"Kamal Mezian, Vincenzo Ricci, Ke-Vin Chang, Nimish Mittal, Jan Vacek, Ondřej Naňka, Levent Özçakar","doi":"10.1002/pmrj.13381","DOIUrl":"https://doi.org/10.1002/pmrj.13381","url":null,"abstract":"<p><strong>Background: </strong>Injections for the piriformis and triceps coxae tendons/bursae have not been described and validated.</p><p><strong>Objective: </strong>To investigate the deep retrotrochanteric anatomy and validate an ultrasound (US)-guided injection technique.</p><p><strong>Methods: </strong>Fifteen sides of the pelvic half/lower limb of formalin-fixed cadaveric specimens were dissected to investigate the deep retrotrochanteric region. An US-guided superficial/peritendinous green latex dye injection was performed on both sides of a single full body cadaver. Next, seven sides of another four full body cadavers were injected using a deep/intrabursal technique. The cadavers were dissected to observe the dye's location.</p><p><strong>Results: </strong>In the anatomical part of the study, we observed a consistent fusion of the piriformis tendon (PT) with the triceps coxae tendon (TCT) (15/15), and with the gluteus medius tendon in 93% (14/15). A bursa of piriformis was identified in 80% (12/15) of the cases, and a subtendinous bursa of obturator internus was found in 73% (11/15). A fat pad overlying the PT-TCT was present in 93% (14/15) of the cases. Regarding the US-guided injections, success rate for superficial/peritendinous injection was 0% (0/2), with the latex dye being identified in the fat pad covering the PT-TCT in both cases. For the deep/intrabursal injection, the success rate was 86% (6/7).</p><p><strong>Conclusions: </strong>The results indicated a satisfactory success rate for the deep/intrabursal injection of PT-TCT in retrotrochanteric pain syndrome. This technique holds promise for the treatment of bursa and tendon pathologies in relevant patients.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of baseline PROMIS-10 scores of mental and physical health of patients with low back pain evaluated by physiatrists and orthopedic spine surgeons.","authors":"Rachel Rothman, Glolabo Sokunbi, G Ross Malik, Ellen Casey, Jonathan Kirschner, Carlo Milani, Harvinder Sandhu, Jennifer Cheng, Heidi Prather","doi":"10.1002/pmrj.13378","DOIUrl":"https://doi.org/10.1002/pmrj.13378","url":null,"abstract":"<p><strong>Background: </strong>Enabling spine patients to access appropriate spine providers based on their course of care can enhance care outcomes. Physiatrists are trained to provide care throughout the continuum of low-back pain (LBP) symptoms and structural conditions that do not require urgent/emergent spine structural intervention.</p><p><strong>Objective: </strong>To assess if patients triaged to a physiatrist for LBP based on where they are in their continuum of spine care will report better baseline physical and mental health than patients presenting to a spine surgeon.</p><p><strong>Design: </strong>Retrospective study comparing physical and mental health (Patient-Reported Outcomes Measurement Information System [PROMIS]-10) in patients with LBP who are triaged for initial evaluations with physiatrists or spine surgeons.</p><p><strong>Setting: </strong>Tertiary orthopedic hospital.</p><p><strong>Patients: </strong>Adult patients presenting with chief concerns of nonemergent/nonurgent LBP to physiatry or spine surgery from April 1, 2019 to July 1, 2021.</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Main outcome measures: </strong>Initial-visit PROMIS-10 mental and physical health scores.</p><p><strong>Results: </strong>A total of 2646 new patients presented to physiatrists (n = 1911 [72.2%]) and spine surgeons (n = 735 [27.8%]). Patients evaluated by physiatrists had higher mental health (physiatry 50.1 ± 8.5, spine surgery 46.7 ± 9.0; p < .001) and physical health scores (physiatry 43.7 ± 7.5, spine surgery 39.8 ± 7.2; p < .001) than those presenting to spine surgeons. Furthermore, patients evaluated by physiatrists were more likely to have mental and physical health scores >55 and less likely to have scores <45 (p ≤ .001). Patients with LBP + lower extremity (LE) pain had significantly lower mental and physical health scores than those with LBP alone (mental health 48.5 ± 8.6 [LBP + LE-pain], 49.9 ± 8.9 [LBP-alone]; physical health 41.5 ± 7.3 [LBP + LE-pain], 44.0 ± 7.7 [LBP-alone]; p < .001).</p><p><strong>Conclusions: </strong>Patients directed to spine surgeons via triage had worse PROMIS-10 mental and physical health, suggesting this subgroup of patients may especially need additional resources to address these issues in the course of their care. Physiatrists provided nearly two-thirds of nonurgent LBP evaluations in this tertiary orthopedic center, serving an important role in the initial evaluation and treatment of nonurgent LBP. The impact on patient outcomes, patient satisfaction, and associated health care costs requires further investigation.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}